Archives: Medical Student Finals

MSFinals-3566

A 27-year-old woman named Priya, who moved to the UK from India 8 years ago, visited her GP with her husband. She was 32 weeks pregnant with her first child. Priya had experienced mild hyperemesis until week 16 but had an otherwise uneventful pregnancy. She reported feeling slightly feverish and unwell, and had developed a rash the previous night.

Upon examination, Priya appeared healthy, with a temperature of 37.8ºC, oxygen saturation of 99% in air, heart rate of 92 beats per minute, respiratory rate of 18 breaths per minute, and blood pressure of 112/74 mmHg. She had a macular rash with some early papular and vesicular lesions.

Further questioning revealed that Priya had attended a family gathering two weeks ago, where she spent time with her young cousins. One of her cousins was later diagnosed with chickenpox. Priya’s husband confirmed that she had never had chickenpox before.

What is the appropriate next step in managing chickenpox in this case?

MSFinals-3567

A 35-year-old woman complains of lower abdominal pain during her 8th week of pregnancy. A transvaginal ultrasound reveals the presence of a simple ovarian cyst alongside an 8-week intrauterine pregnancy. What is the best course of action for managing the cyst?

MSFinals-3568

A 36-year-old woman presents with increasing bloating and mild lower abdominal pain that started 3 hours ago. On examination, there is abdominal tenderness and ascites, but no guarding. She denies any vaginal bleeding. Her vital signs include a heart rate of 98/minute, a blood pressure of 90/55 mmHg, and a respiratory rate of 22/minute. The patient is currently undergoing IVF treatment and had her final hCG injection 5 days ago. She has been having regular, unprotected sex during treatment. A pregnancy test confirms she is pregnant. What is the most likely diagnosis?

MSFinals-3569

A 32-year-old woman from Chad complains of continuous dribbling incontinence following the birth of her second child. She reports no other issues related to her pregnancies and is generally healthy. What is the probable diagnosis?

MSFinals-3570

A 34-year-old woman delivers twin girls without any complications. What medication is commonly administered after delivery to aid in the delivery of the placenta and prevent excessive bleeding?

MSFinals-3571

A 28-year-old woman attends the antenatal clinic at 41 weeks of gestation, worried that she has not yet gone into labour. She reports normal foetal movements and has not been recently ill. She has no significant medical history and this is her first pregnancy. On examination, her abdomen is soft and a palpable uterus is consistent with a term pregnancy. Her Bishop’s score is calculated as 5. What is the first step in managing this patient?

MSFinals-3572

A 25-year-old woman is currently being assessed in the labour ward. She is at 38 weeks gestation and reports that her waters broke 1 hour ago. This is her first pregnancy, and she has had an uncomplicated pregnancy without significant medical history. Upon examination, her Bishop’s score is calculated to be 9, and a vaginal exam confirms that her amniotic sac has ruptured. There are no signs of contractions at this time, and the foetal heart rate is reassuring at 135/min. What is the most appropriate immediate management plan for this patient?

MSFinals-3573

Sarah is a 28-year-old woman who has recently given birth to a baby boy 6 weeks ago. At the 6 week check, you can see from her records that she has previously been on sertraline for moderate depression, however, this was stopped before her pregnancy. She tells you that she is finding it difficult to cope and is feeling extremely low. On examination, she is tearful and has a flat affect. She denies any thoughts to harm herself or her baby but is keen to try a medication that would be safe to use with breastfeeding.
Which of the following medications may be appropriate for her to start?

MSFinals-3574

A 35 year old type 2 diabetic comes to the diabetics clinic seeking advice on her desire to conceive. The patient has well-managed blood sugar levels and is currently taking metformin and gliclazide. What recommendations should you provide regarding potential medication adjustments during pregnancy?

MSFinals-3575

A 30-year-old multiparous female at 10 weeks gestation visits her general practitioner to book her pregnancy. She has a history of gestational diabetes and returns the next day for an oral glucose tolerance test. Her blood results show a fasting glucose level of 7.2 mmol/L and a 2-hour glucose level of 8.9 mmol/L. What is the recommended course of action based on these findings?